Happy New Year 2015!
I’m starting by going backward, to revisit a topic from the
end of last year; perceptions surrounding the origins of HIV. As the gears of
the TB research project grind into action, I thought I’d get a quick fix of
action by getting onto the streets of Kampala and, with help of Robert, ask 3
questions:
1.
Where
did HIV come from? Where did it originate? What is the underlying cause of HIV?
2.
Is
there a cure to HIV?
3.
Are
the origins of Ebola different to those of HIV? Where did Ebola come from?
Firstly, just to clarify, this is not research. Prompted by
some debate at the end of last year, I went out just to gauge some opinions on
the street. If any of you remember, the hypothesis had been created in our
“focus group” – if I asked 100 people on the street you will find 90 that
believe the Americans created AIDS or Ebola.
After one long morning’s work asking 30 people, Robert and I
settled on asking a total of 50 people amongst whom we tried to get as broad a mix as possible,
from the suited and booted (including a trip into 3 pharmacies) to the "average" joe and jane, and a mixture of men, women, young and old. Overall, I think we
got a fairly broad high-street mix, if only with an over-representation of 7
Boda-drivers (always an easy target). In total we asked 36 men and 14 women
with a median age of 30 years and a range between 19 and 70 years.
The Answers…
1.
Where
did HIV come from?
I’m going to start with the most disturbing story, in
content and frequency, told to me by four
people; two university students (who, to be fair, said they no longer believed
it), a shopkeeper and a farmer.
2 young Ugandan ladies were given a lot of money to go
America. The American scientists there had injected a dog with HIV, and the
Ugandan women had sex with the dog (hence the big pay cheque). They then
returned to Uganda and “played” with
several men, starting the HIV epidemic.
The variations on this were the scientist as a rich white
man who just wanted his animals to have pleasure (because of how much western
peope love their pets) – which changed the slant to an accidental transmission
rather than purposeful or a failed lab experiment.
Stories aside, I think the beliefs can largely be split three ways
with a few remainders; “The Accidental Scientist”,
followed by “The Western businessman”,
closely followed by the “The Western
controller”.
The Accidental Scientist
For the 7 people who believed this, it refers to the
accidental infection of Africans by scientists doing experiments, often taking
chimp virus and injecting it into humans. On the whole, there is no
apportion of blame here to the scientists, the release into the public was an
accident. Although, the sinister undertone in a couple of stories is that
Africans were being “tested on” when
they were accidentally infected with HIV. One 70 year old man frankly said that
humans were injected to “see how they would react, like anthrax” (he was a vet…
hence anthrax comparison, I’m guessing).
The Western Businessman
The most commonly held belief, by 14 people (3 in
conjunction with the Western controller), is that it has been created as a
business – to sell medications and potential vaccines to Africans. Allied to
this is the implication and often vocalized belief that it has been created for, and
purposefully injected into, Ugandans. Often the story is murky, with a mixture
of Americans, Europeans, White people as the perpetrator, although one Kampala
City Council Authority parking coordinator had a clear understanding that “in the 1980’s 12 White men came and injected
people with the virus” with the purpose of selling drugs and vaccines.
Looking for evidence, one coordinator for an agriculture NGO exclaimed – “look at how many people are eating ARV’s” –
pointing to the amount of money being made by someone. One pharmacologist noted,
“it is like computers, they make the
virus and the antivirus”.
The Western Controller
9 people (3 cross over with Business man, as above) believed that it has been
created by a variety of Americans/Europeans/Westerners as a method of
population and power control over the continent of Africa. One man who described himself as a
“researcher” for several presitigious universities, including Princeton, said
that HIV has been created to “destroy the
lives of Africans”, although the common conception was just for “population control”. One boda driver
explained that although the aim had been to control the continent, “they” had
not appreciated the strength of African herbs, which can make someone “live for 40 years even with HIV, and have an
AIDS free child”.
Other causes
6 people I would call “misadventure” – this group includes
the dog sex story, as well as one 27 year old security guard who believed that
gay people in the US were having sex with monkeys, and one 45 year old
freelance 4x4 driver, who believed it was used in the Vietnam war as a
biological weapon. There US marines were infected by accident, after which they
were “dumped in the 3rd world” (Zimbabwe, so the
story goes), however Marines like the beach so travelled to the coast, where
they had sex with prostitutes who passed it to the truck drivers, and so the
epidemic starts .The largest other groups were attribution to religion (5
people), either as part of a “punishment”, evidence of the second coming of
Jesus or a creation of the devil, with evidence from the first testament
that it has been present since “time immemorial”. A further 5 people come under
the “don’t know" category. And the final 4 I would term the most correct – reasoning that the virus came from monkeys and chimpanzees, through eating
undercooked bushmeat meat. One did raise the possibility sexual intercourse
with a monkey although this didn’t dominate their answer. All 4 were male, and included a security guard, a local
chief, a building care-taker and a hair salon manager.
All in all, without rigorous quantitative analysis, there
was no clear pattern of occupation, age or sex. Perhaps more women fell on the
religious and scientific accident side (7/14), but not enough to pass comment.
2. Is there a cure?
I’ve touched a bit on cure already – talking about African
herbs (although that was the only mention of herbal remedies amongst the 50 people)
and the business model approach. Exactly half (25) of the people believed there
was a cure. But unanimously this was unavailable to them for a variety of
reasons, centering around inequality of access; only in European/American
countries, only for rich people (“only if
you wallet is happy”), or it was purposefully being kept from them to continue
controlling them or selling them drugs. 2 people described the computer
virus/anti-virus analogy. 2 people also
put a name to it, one 32 year old boda driver describing “Fusion”, while the prestigious “researcher” talked about “Viagra”. Amongst the half who didn’t
believe there was a cure, almost all talked about the controlling effect of
ARV’s, and a few said that people were “trying
to find a cure”, several also mentioned that “rich” and “white” people
die from it as evidence for there not being a cure. A couple of people touched
on a half-way house cure, 2 men had a “sister” who was either taking a 6
monthly injection, or 3 pills a year to control their HIV.
3. Are the origins of
Ebola different to those of HIV? Where did Ebola come from?
Interestingly, the response to Ebola was quite different to
HIV. 30/45 people who answered believed that Ebola was from animals, monkeys or
due to poor hygiene. 11/45 believed it was either from America or an experiment
of some kind gone wrong and a further 4/45 didn’t know. Many talked about the
importance of not eating bushmeat, although on the flip side, one conspiracy
theorist – a 25 year old pharmacist – said that “we have been eating meat for a long time, why is only now they tell us
to stop”, and other talked of the importance of hand-washing. One
gentleman, described the story of 2 elephants who had become ill, were flown to
the US, where they were diagnosed with Ebola, before being flown back and
dumped out of a plane in mid-air into the jungle. In the jungle the local people touched
them and became infected. Two other conspiracy theorists put it down to the
name, “they even have a town in Germany
called Marburg” and, according to a 35 year old businessman, the fact that
it is an infectious disease and so all outbreaks should be connected by people
being infected – the only option for separate outbreaks is someone starting
them separately. He justified his belief that it was American created, as only they had received treatment for Ebola.
How did this all come
about?
I did ask a few people where their beliefs came from and the
answers were very broad, for some they just “know it”, others heard it from their parents, or broader
discussions with friends, one man said he saw it on Youtube and Google and
another even heard it discussed on TV. One interesting and unexpected theme
however was of a musician called Phillip Luutya
- mentioned by 4 people as the source of their evidence for America
having been the source. For example, a 27 year old Security Guard, who believed
that Phillip Luutya had brought the disease back with him from America.
Power and control
If you had asked me 4 months ago what I would have expected
from asking 50 people this question – I wouldn’t have been further from the
mark. Which for begs the question: Why does Average Joe and Jane Uganda hold
these beliefs of Western HIV origins? And why is it different for Ebola?
I’m going to put forward two theories that share a
commonality of power and control. The first was my initial thoughts when Robert
and I tramped the streets of Kampala, and the second came up during a lucky
dinner conversation.
When it comes to HIV, the inequity of the 90/10 gap is
glaringly obvious. Relative to their need, the Western patient has 90% of the
resources, 90% of the information. Western governments and research
institutions hold the key (and wallet) to 90% of the research. The West
discovered disease, named it with a Western name and found the treatments with
more Western names and now funds 90% of treatment in developing countries. The
face of the mzungu in the epidemic is the benefactor and knowledge and
capability portal. With this inequity in mind while I listened to people’s
responses, it struck me that HIV is not something that the average Ugandan has
their own locally sourced understanding of in the same way that they for
malaria (or more recently Ebola?) – its something that in every aspect from its
discovery to treatment is associated with, essentially, the rich mzungu. Like
computers, they create the virus and the anti-virus.
The contrast to this is Ebola which, although it was
“discovered” by the West, is managed and diagnosed successfully by the Ugandan Ministry
of Health (with some help), and perhaps the people have developed some
ownership of it and assimilated it into their understanding of the world.
The second theory (which perhaps is more concrete in
evidence) came over dinner with my friendly German hosts, who mentioned a
series of articles, triggered by the recent release of some E German WW2
archive files, regarding the Eastern Bloc countries who, during the Cold War battle
for the heart of Africa, created Operation INFEKTION. This smear campaign
against the Americans started in 1985 with the release of the Segal Report, a
pseudo-scientific paper, which suggests that HIV could be man-made. The
communist propaganda machine subsequently used this across the world to, quite successfully allege
that Americans created HIV. Perhaps this is still the aftermath of that? As
Wikipedia notes, one study in the US in 2006 found that amongst
African-Americans 50% believed HIV was man-made.
Does it matter that
you believe that another power has cause the HIV epidemic in your country?
I never specifically asked about the measures people can
take to protect themselves or others from HIV, but it was very clear from answers
that knowledge was good. Knowledge of the availability of ARVs was almost
universal, and people unprompted would often tell me about the importance of abstinence,
being faithful, reducing your number of partners and using condoms. There was a
genuine fear of HIV and appreciation amongst many of the importance of avoiding
infection, wherever they can. With all this in mind, does where you think it’s
from matter, when understanding of how it spreads and what you can do about it
is good? In the same way that the Ebola crisis forced a confrontation with
peoples beliefs and understanding, if it doesn’t already (which there is some evidence
to say it does), I think at somepoint it will.
Apologies that this is a long one, and for anyone who has
read to the end – I hope it was worth it! Two articles from the Ugandan press
to sign off on – firstly, if you found the dog-sex story difficult to believe,
here is allegations from the trade minister that Ugandan women who go to work
abroad are forced to breastfeed dogs and tortoises. And secondly, unlike this
journalist, who gave Museveni a 55% lead over his nearest rivals in the polls
(if you are going to cheat, just cheat a little bit), I did not make up my
results. Also, if anyone is interested (and has an Athens login) here is a recent article on the origins of HIV.
